Blastomycosis of the eyelid

BACKGROUND: Published reports indicate that eyelid involvement occurs in approximately 25% of patients with systemic blastomycosis and that mortality exceeds 60% in untreated patients. The purpose of this study is to investigate this purportedly frequent association. METHODS: The Medical Diagnostic index of the Mayo Clinic was used to identify patients who were treated for blastomycosis from 1976 through 1993. The medical records of affected patients were reviewed. RESULTS: Of 79 patients with blastomycosis, only 1 (1.27%; 95% confidence interval, 0.03%-6.85%) had eyelid involvement. The diagnosis of systemic disease was established in this patient after biopsy of the eyelid lesion, and the infection responded satisfactorily to treatment with itraconazole. CONCLUSION: Contrary to previous reports, eyelid involvement with systemic blastomycosis is uncommon.